Provider Demographics
NPI:1073960852
Name:ASIKE, CHINELO (CRNP)
Entity Type:Individual
Prefix:
First Name:CHINELO
Middle Name:
Last Name:ASIKE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9055 CHEVROLET DR
Mailing Address - Street 2:#103
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4016
Mailing Address - Country:US
Mailing Address - Phone:410-465-7850
Mailing Address - Fax:
Practice Address - Street 1:9055 CHEVROLET DR
Practice Address - Street 2:#103
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4016
Practice Address - Country:US
Practice Address - Phone:410-465-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200538363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily